VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1709677
Sex: F
Age: 24
State: MN

Vax Date: 01/05/2021
Onset Date:
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: TESTED POSITIVE FOR COVID 9/15/2021

Other Meds:

Current Illness:

ID: 1709679
Sex: F
Age: 81
State: CA

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies: SULFA AND CODEINE

Symptom List: Anxiety, Dyspnoea

Symptoms: RED, WARMTH, RASH

Other Meds: NONE

Current Illness: NO

ID: 1709680
Sex: F
Age: 24
State: TX

Vax Date: 09/02/2021
Onset Date: 09/06/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: COVID test (negative) 9/7/2021 Strep test (negative) 9/7/2021 Dx: Sinusitis, even though patient declared vaccination

Allergies: None known

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Woke up on 9/6/2021 with sore throat, headache, sound sensitivity, chills, runny nose. Contacted AF nurse health line, advised to get tested for Covid. Tested negative. Advised to go to where tested negative for strep and given Augmentin EQ 875 mg and BromPhen/PSE/DM. Developed lower back and chest pain, which migrated up into upper back and then into sternum over next 2 days. Main symptoms continued for 4 days, accompanied by joint pain. Coughing and headache finally fading today, 11 days later. Fatigued; sleeping 10+ hours a night since shot.

Other Meds: Glutathione, Quercetin, Resveratrol/Curcumin

Current Illness: None

ID: 1709681
Sex: F
Age: 38
State: MN

Vax Date: 07/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: URI symptoms which started 2 or 3 days ago. Of concern is the fact that she lost her sense of taste and smell and she had a fever

Other Meds: Famotidine

Current Illness: none

ID: 1709682
Sex: F
Age: 38
State: MD

Vax Date: 09/07/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: CTA Chest TTE Troponin I Antiphospholipid Syndrome CT Head

Allergies: none

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Syncopal episode found to be massive PE requiring intubation with associated right heart strain (estimated BOVA 4).

Other Meds: - Metformin 1500mg once daily - norethindrone-ethinyl estradiol (ALAYCEN 1/35) 1-35 MG-MCG tablet once daily

Current Illness: Issues with contraception

ID: 1709683
Sex: F
Age: 80
State: IL

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: MRI, CAT SCAN, HEART TEST (using sound) MRI ALL ON MAY 22, 2021

Allergies: NONE

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: ISCHEMIC STROKE WITH EMBOLISM IN BASAL ARTERY. SYMPTOMS: HEADACHES, BRAIN FOG, BALANCE EFFECTED, SOME BREATHING PROBLEMS, FATIGUE

Other Meds: NONE

Current Illness: NONE

ID: 1709684
Sex: M
Age: 26
State: CA

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Pt had nl ekg, nl cbc, nl chem 7, and neg trop. Observed for a couple hours with nl VS noted.

Allergies: NONE

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt had Janssen vaccine at 1:30 pm on 9/16. at clinic. Presented to Emergency Department at 1:45 am after fainting episode x 2.

Other Meds: IBUPROFEN PRN

Current Illness: none

ID: 1709685
Sex: F
Age: 59
State: WA

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Sensitive to most prescription drugs

Symptom List: Pharyngeal swelling

Symptoms: Swollen lymph node left armpit

Other Meds: Aviane

Current Illness: None

ID: 1709841
Sex: M
Age: 52
State: FL

Vax Date: 04/29/2021
Onset Date: 07/28/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: MRI's, CT scans, blood work, Plasma Exchange, Lumbar Puncture and numerous other tests. He was hospitalized 7/28/21 for 4 days and then again 8/11/21 through 9/2/21.

Allergies: NKA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache and sinus related symptoms immediately following vaccination and was ongoing. on 7.28.21 was falling, very dizzy and had tingling in his feet and legs. Was hospitalized for 4 days and released after MRI, CT scans, COVID testing and blood work came back normal. He was given IV fluids and medication for dizziness. 2nd Onset of symptoms ..... Extreme lower extremity weakness, falling, dizziness, diarrhea, tingling in feet approximately 1 week prior to 7/28/21. On 7/28/21 lost feeling in both feet and L leg up to the knee, R leg lost feeling from foot to mid thigh, very unstable walking, progressive paralysis present in both lower extremities and above R knee. Lost the ability to stand on his own or to walk. He fell around 3 pm and was taken to Health Center where tests were normal results. A lumbar puncture was done and was positive for high levels of protein present in his spinal fluid and diagnosed with Guillian Barre' Syndrome. He was admitted and Plasma Exchange was started immediately the next day. there were 5 exchanges done in 10 days. At this point he had started to regain some feeling and movement in his right leg and foot and was admitted into the hospitals Inpatient Physical Therapy Program . He was in intensive physical therapy and occupational therapy for the next 8 days. Upon discharge he was able to walk with assistance of another person using a walker and/or cane. To this date he has not regained any feeling to his right leg, has hand tremors, severe back pain and balance issues. He is unable to drive or work, having to resign his fulltime position as a forklift operator. He requires assistance with all ADL including bathing, preparing meals, and transportation to and from all appointments. He is now taking several medications to help him with the nerve pain and affects of this chronic illness. He is a fall hazard due to his unstable gait and posture. His right foot and leg is still paralyzed and unable to bear weight. He is in in home physical therapy twice weekly. Prior to taking the vaccine and developing this illness he was able to live a normal life and worked full-time 10 hr shifts at a time. He requires periodic resting now throughout the day and is unable to earn a income.

Other Meds: Depakote Buspar Citilopram

Current Illness: None

ID: 1709842
Sex: F
Age: 40
State: UT

Vax Date: 04/26/2021
Onset Date: 05/01/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Lack of taste, no treatment, ongoing

Other Meds:

Current Illness:

ID: 1709843
Sex: M
Age: 83
State: MN

Vax Date: 02/25/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: cold symptoms for about 5 days starting on 9/11/21 (sore throat, sinus congestion, nasal congestion). Note wife also tested positive for COVID same day he did

Other Meds: Aspirin; calcium; Lisinopril; Simvastatin; Sotalol; Sildenafil; Novolin; Tamsulosin; Metformin

Current Illness: none

Date Died: 08/26/2021

ID: 1709844
Sex: M
Age: 67
State: IA

Vax Date: 04/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None known

Symptom List: Rash, Urticaria

Symptoms: My father went to thr hospital for knee pain and was admitted to the ER same day saying he had COVID. He spent 4 days in ER and was then transferred to local ICU. After a couple days he was released from ICU into a room in the hospital. At somepoint here, he was sedated by hospital staff because they said he was taking tubes out of his body and stuff. He never came too after be sedated, and was moved back to the ICU. Another few days passed with no one havimg a clue what was going on and finally MRI was conducted MRIs by the doctor revealed 'numerous strokes in his brain.' He died on August 26, 2021

Other Meds: He took blood pressure medication and insulin

Current Illness:

ID: 1709845
Sex: F
Age: 18
State: MI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: n/a

Allergies: n/a

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: The patient came in for her 2nd dose of the Moderna COVID-19 vaccine. I neglected to double check the CDC COVID-19 vaccination card, her MCIR or let her know which vaccine she was receiving. after I gave her the vaccine and she had waited 15 minutes I was then able to check the billing information that the technician put in. this is when I noticed that the patient was suppossed to receive the Moderna vaccine and that I had given her the Pfizer COVID-19 vaccine instead. I contacted my boss, the patient's doctor and the patient. The doctor had stated that they didn't see any issue with the differing vaccines. The patient stated that she felt fine. The patient's aunt followed up with the pharmacy manager from the vaccination site on 9-17-2021. There were no adverse events.

Other Meds: n/a

Current Illness: n/a

ID: 1709846
Sex: F
Age: 66
State: NY

Vax Date: 02/02/2021
Onset Date: 08/09/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: 6 months after vaccine blood clots went from my legs to my lungs and I went into cardiac arrest

Other Meds: Entresto, metoprolol, trulicity, Lipitor

Current Illness: none

ID: 1709847
Sex: M
Age: 56
State: NC

Vax Date: 07/31/2021
Onset Date: 08/06/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: X-ray for elbow showed signs of arthritis not present before. I have not seen a doctor for brain fog

Allergies: None

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: 1) Typical side effect after shot 2 - fatigue. 1 day 2) Tendonitus Right Arm- tennis elbow, arthritis- onset 1 week after shot, cortisone shot. Not effective. Reported to Dr who said research is inconclusive but there have been reports 3) Experiencing ? brain fog? loss of balance, innattentiveness, extreme fatigue since 2nd shot, ongoing

Other Meds: None

Current Illness: None

ID: 1709848
Sex: F
Age: 37
State: FL

Vax Date: 09/10/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Nome

Allergies: None

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Miscarriage at week 11 and 6 days Due date 3/31/22

Other Meds: Synthroid

Current Illness: None

ID: 1709849
Sex: M
Age: 80
State: GA

Vax Date: 02/13/2021
Onset Date: 02/27/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: I was treated in an attempt to recover the hearing. Meniere's disease is also thought to have been the problem. No one knows for sure.

Allergies: None

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Sudden loss of hearing in left ear. I had lost hearing suddenly 6 days after the first shot, but hearing recovered completely the next week. The hearing did not recover after the second shot.

Other Meds: Benicar, Atenolol, Amlodipine, Fiber Caps, Multi vitamin

Current Illness: None

Date Died: 04/25/2021

ID: 1709850
Sex: M
Age: 47
State: MA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: No allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: No symptoms

Other Meds: Blood pressure, Insulin, Gabapentin, venafaxaline

Current Illness: Afib, Diabetes, Neuropathy, High blood pressure

ID: 1709851
Sex: F
Age: 45
State: VA

Vax Date: 09/01/2021
Onset Date: 09/05/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: Missed period!

Allergies: None.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I had my 1st shot on 4/1/2021 & I missed my period by about 3 days, but I didn?t think anything of it. I had my 2nd shot on 4/22/2021, and I was tired, had a sore arm and mild temp just like with my 2nd shot, and I just figured it was normal. On 9/1/2021, I had my 3rd booster shot. I have PCOS, but my periods are normal. I am overweight. I also have high blood pressure. I did feel tired after the 3rd COVID shot, no temperature that time, but the 5th came, and I didn?t have my period. I?m not pregnant. I have not had sex for over a year now. I didn?t think about my period til I checked my calendar, and noticed that my period is now 12 days late!

Other Meds: N/A

Current Illness: None.

ID: 1709852
Sex: F
Age: 50
State: FL

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Procadia, norcotics

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Myself and my husband got the vaccine from the same vial; however, both shot caused adverse events to me. Constipation for about two weeks, nausea, extreme severe muscle and joint pains to my entire body. Muscle weakness, extremely fatigue, loss of appetite. Legs felt tired and burning nerve pain to my left leg from thigh to ankle, also on about 8 days later, the opposite hand became very painful requiring a sling. Nothing happened to my husband. The second dose gave me a temperature of 101.9 to 104.7 and extremely painful joints.

Other Meds: None

Current Illness: No

ID: 1709853
Sex: F
Age: 36
State: OR

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, Tetracycline, Metoprolol

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Tinnitus in right ear : after loud sounds or music, wind, etc. Sounds like stereo feedback.

Other Meds: Prednisone, Xarelto

Current Illness:

ID: 1709854
Sex: F
Age: 16
State: TX

Vax Date: 09/12/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: On the day following the vaccine, she developed itchiness of both ears which spread to her entire face. She also has facial edema, erythema with a few erythematous papules scattered over her cheeks.

Other Meds: Lisinopril

Current Illness: None

ID: 1709855
Sex: M
Age: 54
State: OH

Vax Date: 06/29/2021
Onset Date: 07/15/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Haven?t done any medical tests.

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: There has been consistent pain in my right arm and neck. I can?t raise right hand high enough when I?m wearing clothes or anything that requires me raising my arms.

Other Meds:

Current Illness:

ID: 1709856
Sex: F
Age: 66
State: MD

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: NA

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Swollen cheeks and upper lip

Other Meds: Duloxetine, Metafolbic Plus, Ibanodrate sodium, Metronidazole gel, Gabapentin, Rosuvastatin, CBD, CoQ10, Curcumin phytosome, Krill oil, N-acetylcysteine, Vitamin D, AlgaeCal Plus, Melatonin

Current Illness: None

ID: 1709857
Sex: F
Age: 86
State: MN

Vax Date: 02/25/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: nasal congestion feels like she has a head cold, headache starting 9/14/21. Note: husband also tested positive for COVID on same day, he also was vaccinated

Other Meds: Losartan; Calcium; Glucosamine-Chondroitin; Atorvastatin; Metformin

Current Illness: none

ID: 1709858
Sex: M
Age: 41
State: NM

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Angioedema (swelling of throat); no treatment; swelling resolved 4 hours after start; event was not reported to a health care facility until patient arrived for 2nd shot

Other Meds: N/A

Current Illness: N/A

ID: 1709859
Sex: F
Age: 63
State: MN

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Imitrix

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Chills Headache Extreme fatigue Nausea Rash Pain, swelling, redness at injection site

Other Meds: Trazodone/sertraline/Zoloft/ Vitamin D, zinc, fish oil, magnesium, D- Mannose, multivitamin, Prilosec

Current Illness:

ID: 1709860
Sex: U
Age: 30
State: WA

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 09/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data: this is private info. not subject to disclosure. I'm not going to be a guinea pig.

Allergies: none I ONLY got 1st Mederna covid shot. No way I'll get 2nd shot for any local vaccine. Covivak only. After I got 1st Mederna covid shot, I got 1 time in urgent care and 2 times in hospital. Those symptoms still with me for 2+ month. Sometimes still feel like they are coming back for 3-6 days now. Symptoms: - disorientation (4+ days) - blond syndrome (extreme uncontrolled silliness, not adequate behavior, unable to quickly make decision, not sharp thinking, can't concentrate, fall into a stupor, memory loss) - still have it from Mederna covid shot - shortness of breath - fever - sore throat - runny nose - pain in the upper chest (like bronchitis) - fatigue - enlargement and soreness of the lymph nodes armpits (also itching) - place of injection is red like red, swollen and itchy (15X15cm) - very sleepy - dyspnea (even when going on 2nd floor in my house - out of breath), - pallor of skin - constant fatigue - fast heartbeat -dizziness and weakness - chest pain VERY abnormal blood test in hospital

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I ONLY got 1st Moderna covid shot. No way I'll get 2nd shot for any local vaccine. Covivak only. After I got 1st Moderna covid shot, I got 1 time in urgent care and 2 times in hospital. Those symptoms still with me for 2+ month. Sometimes still feel like they are coming back for 3-6 days now. Symptoms: - disorientation (4+ days) - blond syndrome (extreme uncontrolled silliness, not adequate behavior, unable to quickly make decision, not sharp thinking, can't concentrate, fall into a stupor, memory loss) - still have it from Moderna covid shot - shortness of breath - fever - sore throat - runny nose - pain in the upper chest (like bronchitis) - fatigue - enlargement and soreness of the lymph nodes armpits (also itching) - place of injection is red like red, swollen and itchy (15X15cm) - very sleepy - dyspnea (even when going on 2nd floor in my house - out of breath), - pallor of skin - constant fatigue - fast heartbeat -dizziness and weakness - chest pain VERY abnormal blood test in hospital

Other Meds: I ONLY got 1st Mederna covid shot. No way I'll get 2nd shot for any local vaccine. Covivak only. After I got 1st Mederna covid shot, I got 1 time in urgent care and 2 times in hospital. Those symptoms still with me for 2+ month. Sometimes

Current Illness: none I ONLY got 1st Mederna covid shot. No way I'll get 2nd shot for any local vaccine. Covivak only. After I got 1st Mederna covid shot, I got 1 time in urgent care and 2 times in hospital. Those symptoms still with me for 2+ month. Sometimes still feel like they are coming back for 3-6 days now. Symptoms: - disorientation (4+ days) - blond syndrome (extreme uncontrolled silliness, not adequate behavior, unable to quickly make decision, not sharp thinking, can't concentrate, fall into a stupor, memory loss) - still have it from Mederna covid shot - shortness of breath - fever - sore throat - runny nose - pain in the upper chest (like bronchitis) - fatigue - enlargement and soreness of the lymph nodes armpits (also itching) - place of injection is red like red, swollen and itchy (15X15cm) - very sleepy - dyspnea (even when going on 2nd floor in my house - out of breath), - pallor of skin - constant fatigue - fast heartbeat -dizziness and weakness - chest pain VERY abnormal blood test in hospital

ID: 1709861
Sex: F
Age: 57
State: ID

Vax Date: 02/23/2021
Onset Date: 03/16/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Unfortunately i didn't seek medical attention, symptoms were fairly mild but I am convinced I had myocarditis. It pretty much resolved itself by 8/1/2021

Allergies: none

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Symptoms of myocarditis - shortness of breath, heart palpitations, heart pain

Other Meds: levothyoxine and multi vitamin

Current Illness: none

ID: 1709862
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Took over the counter antihistamines; several dads later hives are returning

Allergies:

Symptom List: Nausea

Symptoms: Severe hives

Other Meds:

Current Illness:

ID: 1709863
Sex: M
Age: 11
State: WA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: NKA

Symptom List: Injection site pain

Symptoms: The patients father gave us the wrong birthday and mislead the pharmacy into thinking the patient was 12 years old.

Other Meds: None to my knowledge

Current Illness: None to my knowledge

ID: 1709864
Sex: M
Age: 47
State: NV

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient came in for second dose of Moderna. Registration checked him on the system, which showed he only had one dose of Moderna (WebIZ: 5377664). Second dose was given and after his observation period, on the way out, he told registration that it was his fourth dose of the vaccine and showed them a picture of his Pfizer card. No adverse events were noted during time of observation. WebIZ was searched using his birthday and he had both Pfizer vaccinations under the name (WebIZ: 3791774). Both IDs on WebIZ have same birthday and address on file, just different first name.

Other Meds:

Current Illness:

ID: 1710052
Sex: M
Age: 82
State: AZ

Vax Date: 08/16/2021
Onset Date: 09/12/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Confirmed by Ophthalmologist

Allergies: hexachlorophene

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Bell's Palsy

Other Meds: warfarin metropolol methotraxate folic acid

Current Illness: Rheumatoid Arthritis Atrial Fib

ID: 1710053
Sex: F
Age: 39
State: MD

Vax Date: 03/30/2021
Onset Date: 04/19/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: I did receive a lot of testing and bloodwork, all of which came back normal at the time tested, including: April 26, 2021: ? Comprehensive metabolic panel ? CBC w/auto differential ? Thyroid testing algorithm ? Vitamin B12, vitamin D (25-hydroxy) total ? HCG qualitative, serum April 29, 2021: ? Microscopic examination ? C-reactive protein ? Rheumatoid factor ? Sedimentation rate ? Tissue transglutaminase IgA ? Urinalysis ? Lyme antibodies screen, w/RFL to WB April 30, 2021: ? D-Dimer, quantitative May 7, 2021: ? Epstein Barr virus antibody panel ? Anti DNA, double stranded ? RO52, RO60 and LA IGG, serum ? Anti-RNP/SMITH antibody ? Hepatitis C Antibody ? Thyroperoxidase (TPO) antibody ? Ferritin ? Iron, TIBC, % transferrin saturatio May 24, 2021 (after symptoms had subsided ? this was the earliest appt available): ? Echo transthoracic complete (TTE)

Allergies: Allergic to dust mites

Symptom List: Tremor

Symptoms: Started feeling extremely fatigued/exhausted on 4/19/21 (approx. 3 weeks after 2nd Pfizer COVID vaccine dose). Onset of exhaustion was acute and lasted for 3-4 weeks. Felt exhausted after full nights of 8-10 hours of sleep. Just walking up or down a single flight of stairs made me feel ?spent,? although I had been comfortably running 8-12 miles prior to the onset of symptoms on 4/19. Could not complete a full day of work (at my computer) for 2 weeks after symptom onset, due to physical and mental exhaustion. ?Brain fog? symptom lasted for 2 weeks only and then went away abruptly (I just woke up feeling clear-headed), but the physical exhaustion lasted over 3 weeks from symptom onset. Never experienced chest tightness, but just needed to catch breath after/during activity during this period of physical exhaustion. Also missed my menses after receiving 2nd dose of vaccine and was not pregnant. Received 2 negative COVID tests 10-12 days after symptom onset, and after having had extremely limited exposure to anyone outside of my home. Visited my PCP 3 times while symptoms lasted and also got a special appointment for an echocardiogram. I received no diagnosis during these visits.

Other Meds: Junel FE Vitamin D Women's Multivitamin

Current Illness: NA

ID: 1710054
Sex: F
Age: 48
State: PR

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: I do not have any

Allergies: Aspirin

Symptom List: Erythema, Pruritus

Symptoms: Very strong headaches after the second say to present. Menstrual period on August 20 I had my period on September 1 at night started with heavy bleeding and clots all week. I had a strong current in my head, my vision went dark for a period of 5 minutes, I was dizzy all day and to this day my headaches do not go away.

Other Meds: Tylenol before the vaccine and at night Neurontin 600 and elavil .25

Current Illness: Fibromyalgia and Von Willebrand

ID: 1710055
Sex: M
Age: 74
State: FL

Vax Date: 09/07/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data: none

Allergies: none

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Skin eruptions

Other Meds: rovustatin

Current Illness: none

ID: 1710056
Sex: F
Age: 33
State: CA

Vax Date: 08/30/2021
Onset Date: 09/05/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: swollen/sore lymph node in left armpit, breastfeeding at time and clogged ducts occurred on the same left side with the lymph node

Other Meds:

Current Illness:

ID: 1710057
Sex: M
Age: 35
State: OK

Vax Date: 09/05/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: RAPIDCOVID TEST ON 9-15-21 WHICH WAS NEGATIVE FLU AND PCR COVID TEST ON 9-16-21 WHICH BOTH WERE NEGATIVE (FLU ON 9-16-21 AND COVID ON 9-17-21).

Allergies: SHELLFISH, SULFA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: SYMPTOMS STARTED AROUND 9 DAYS AFTER SHOT, BEGAN WITH INCREASED HEART RATE, TEMPERATURE FLUCTUATING FROM 101-95 WITH SWEATING COLD SPELLS, WITH TROUBLED BREATHING, WHEEZING AND COUGHING UP PHLEM, ALSO FROM CHECKING WITH FITBIT WHICH I KNOW IS NOT EXACT HEART RATE IS HIGHER THAN NORMAL. TO THIS DATE I'M STILL DEALING WITH ALL THE SAME ISSUES MINUS THE FEVER. CURRENTLY GIVEN METHYLPREDNISOLONE AND AZITHROMYCIN

Other Meds: PREGABALIN, BROPROPRION, ALPRAZOLAM

Current Illness: NONE

ID: 1710058
Sex: F
Age: 57
State: VA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: September 1, 2019 blood test for HAE, type 3 ++

Allergies: very slight to bananas, latex mild irritation

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: ANAPHALAXIS, TONGUE SWELLING FOLLOWING INJECTION, REPEATED TONGUE, FACE, NECK CHEST ABDOMIN SWELLING, REPEATED LY HOURLY THROUGH sEPTEMBER 11, 2021, NOW CONSTANT ABDOMINAL SWELLING WITH HUGE SWELLS AND INTERMITTANT TONGUE SWELLS., FACE SWELLS, NECK AND CHEST SWELLS. Roof of mouth swells, causing loose teeth. Swelling made the patient unrecognizable. Patient began 150mg Orladeyo for type 3 HAE on September 3, 2021, which has slowed the swells and slightly lessened severity, but not eliminated them. High doses of Prednison, benedryl, and Pepsid did nothing to reduce or eliminate the swelling, anaphalaxis.

Other Meds: 25mg Hydrochlorothiazide Vitamin D once per week

Current Illness: none

ID: 1710059
Sex: F
Age: 67
State: FL

Vax Date: 08/05/2021
Onset Date: 08/16/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Numerous tests to include an ultrasound and currently have a procedure scheduled.

Allergies: Gluten, dairy

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: 10 days after receiving the (first) dose, I began intermittent spotting (post-menopausal). Five weeks after, I started bleeding heavily with large clots.

Other Meds: Synthroid, Vitamins B, C, D3, K2

Current Illness: None

ID: 1710060
Sex: F
Age: 36
State: CO

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: 12 lead by EMS to check heart condition

Allergies:

Symptom List: Pain in extremity

Symptoms: Patient complained of dizziness, nausea, lightheadedness, fast heart rate, brief lost of vision, trouble breathing. EMS 911 was called and provided services to the patient for an hour. Patient went home as advised by EMS.

Other Meds:

Current Illness:

ID: 1710061
Sex: F
Age: 49
State: VA

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: at 5:35 pm nurse on staff notes: numbness + tingling in bilateral (hands, feet, lips, and head, starting 2-5 minutes after IM injection - Moderna) + coughing , shortness of breath, feeling tremors/pain in lips and left upper abdominal area. 5:58 pm BP 122/75 - HR 57 6:15 pm BP 121/82 - HR 57 6:22 pm coughing persisting+ headache +tremors Assessment: lungs clear, no wheezing, hear sounds normal S1 S2, no swelling/edema

Allergies: Allergy to cold medication (syrup) - to drug used in nuclear stress test - Allergy to paprika, green pepper, black pepper, white pepper, cumin, safran, spices, shrimp, celery, cabbage, broccoli, tomato sauce, avocado, carrageenan, annatto, canola oil

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: I got the first Moderna vaccine shot at 5:30 pm on 9/17/2021 approximately. Within seconds, I experienced an immediate adverse allergic reaction that required the nurses and professionals on staff to move me to an adjacent chamber and monitor my symptoms for the next hour: numbness, tingling in bilateral hands, feet, lips, and head; coughing, shortness of breath, tremors, pain in lips, and upper left abdominal, head pressure, tongue slowness/slurring words, blurred vision, slowed cognition? As the center was preparing to close for the day, the center staff warned me that I may need to go to the emergency room, if my symptoms persisted or worsened overnight. They also asked me to contact my Doctor and inform her of my immediate adverse reaction to the first dose of the vaccine. They alerted me, per CDC guidelines, that anyone experiencing such a reaction to the vaccine should not receive a second dose and directed me to update my Doctor. They also filed a report documenting this incident with Health Department and other related authorities. Two hours before receiving the vaccine, I met with my allergist/immunologist to determine whether I should be exempt from receiving the vaccine due to my allergies as she had stated to me in July 2021. Instead, she stated that I did not have an allergy to PEG and that I should proceed with receiving the Moderna vaccine as required by my employer.

Other Meds: Lipitor 40 mg - Levothyroxine 100 mcg - Aspirin 80 - Ibuprofen 500 mg - multi-vitamins - vitamin D - Vitamin E - Fish oil

Current Illness: High cholesterol (380 in July 2021 - take Lipitor 40 mg and aspirin 81) - Hypothyroid (levothyroxine 100mcg)

ID: 1710062
Sex: F
Age: 29
State: MS

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: I?ve had a red spot on my arm that tripled in size and felt it had fever to it at/near site of injection. The redness lates 2-3 days but heat sensation is there.

Other Meds: Naproxen

Current Illness: No

ID: 1710063
Sex: F
Age: 55
State: LA

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Very tired with shaking chills and fever of 101.1 from about 9:30 am on 9/15 through until 09/16 about 3 am. My arm is very hard and swollen and a warm bright red down to the bottom of my bicep. Very painfull

Other Meds: One a day fruit bites multivitamin

Current Illness: None

ID: 1710064
Sex: F
Age: 30
State:

Vax Date: 09/08/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Arm is warm and throbbing

Other Meds:

Current Illness:

ID: 1710065
Sex: M
Age: 17
State: MI

Vax Date: 04/01/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Echo and x-ray scheduled.

Allergies: NA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chest tightness/pain. Abnormal EKG. Pericarditis.

Other Meds: Prevacid Solutab

Current Illness: NA

ID: 1710066
Sex: M
Age: 30
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: My PCP had me squeeze his finger to check for grip strength and said im fine (im not fine, my arm is numb)

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: For three days, i had difficulty lifting my arm from severe burning pain. Ever since the first shot, my arm has been numb, tingling, and burning.

Other Meds: None

Current Illness:

ID: 1710067
Sex: F
Age: 20
State: AZ

Vax Date: 05/31/2021
Onset Date: 07/30/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: CT on July 30th

Allergies: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Woke up 10am July 30th with Tinnitus in left ear. First vaccine was on May 31st. By 1pm, I lost hearing completely out of my left ear I went to the hospital and they found no cause Still slight tinnitus and hearing loss

Other Meds: Colchicine .5mg

Current Illness: N/A

ID: 1710068
Sex: F
Age: 66
State: NY

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: Sulfa, Cillins, Kefflex, Lobster, Serrano Pepper, Shrimp

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Pressure to back of head when injected. About 5 hours later chills and fever started. Very tolerable. An hour after that, a bad headache started. It was unbearable. IT WAS UNBEARABLE. It lasted 40 hours. At that point I still had a bad headache but I could walk and talk. As the week went on it slowly got better. If I tried to do normal activities for a few hours, then I would get dizzy and more headachy again and would have to lie down. So after a week of this I called my family physician. Over the following week (week 2 after shot) I continued to feel better so I didnt call my doctor back. He instructed me to call in a week if I was not getting better.

Other Meds: Women's Vitafusion Vitamins, Areds Preservision, Meloxicam

Current Illness: None

ID: 1710069
Sex: M
Age: 54
State: IL

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: none

Allergies: none

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Progressively worsening cough over several hours lasting 2 days

Other Meds: atorvastatin, albuterol

Current Illness: COVID 19

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am